How Catholic Bishops Are Shaping Health Care In Rural America

Almost as soon as President Trump took office, he began rolling back health care rules that had angered religious groups for much of the last decade. First, Trump signed an executive order declaring that his administration would protect religious freedom. Then, his administration ruled that health insurance plans offered by large employers don’t have to cover contraception for employees, an about-face from a contentious Obama policy. The Department of Health and Human Services created a Conscience and Religious Freedom Division, signaling a new focus for the agency. A proposed rule could require all 5,500 hospitals in the U.S. to post notices informing individuals and entities that they are protected from religious discrimination.

The changes are all designed to ensure that employers, health care institutions and providers don’t have to participate in health care practices they object to for ethical or moral reasons. But even decades before the Trump administration moved to roll back Obamacare policies, some religious hospitals — in particular, Catholic hospitals — already had the green light from the government to deny certain treatment options to their patients. These hospitals’ right to refuse care is generally unquestioned, creating a dilemma for the people who walk in the door: What happens when you need or want a standard medical service, but the hospital won’t provide it?

In a growing number of communities around the country, especially in rural areas, patients and physicians have access to just one hospital. And in more and more places, that hospital is Catholic. That sounds innocuous — a hospital is a hospital, after all. But Catholic hospitals are bound by a range of restrictions on care that are determined by religious authorities, with very little input from medical staff. Increasingly, where a patient lives can determine whether Catholic doctrine, and how the local bishop interprets that doctrine, will decide what kind of care she can get.